Monday, April 21, 2014

Pregnancy Loss Resource: Coming to Term, a book to explore the medical side of miscarriage

This book review is an updated version of a post that originally appeared on my old blog, Messy Wife, Blessed Life, on April 21, 2014. This post contains an Amazon affiliate link.

Coming to Term: Uncovering the Truth About Miscarriage by Jon Cohen

Coming to Term is a different type of miscarriage book - it's purpose is not to comfort women or share personal narratives and coping strategies. Instead it explores the scientific research behind miscarriage which, in it's own way, can be a comfort to those who have experienced pregnancy loss.  The author, Jon Cohen, is a journalist who, after having gone through his wife's multiple losses, noticed that doctors seemed to have very few concrete facts about miscarriage and set out to discover the scientific truth behind miscarriage himself by piecing together the scant medical research on the topic.

I read Coming to Term after my first miscarriage and was a bit ambivalent about it; after having a second miscarriage soon after, I'm grateful to have read it.  Knowing some concrete facts about the causes of miscarriage and some of the potential treatments kept me from losing hope after my second loss.  I still often repeat to myself the statistic that Cohen shares: a woman who has a history of repeat miscarriages - three or more - still has a 70% chance of carrying a pregnancy to term without medical intervention.

Perhaps the biggest lessons to be learned from this book is that miscarriage is more common than it was once thought, is largely still a mystery, and most miscarriages cannot be prevented.  Those are some tough facts to face for women that want answers and treatments, but can also be a comfort to know the truth, especially for the many men and women who are told conflicting, outdated, and non-evidence-based information from various medical professionals.

In additional to the hopeful statistics for future pregnancies, the two additional pieces of information that I have felt most useful to me are: 1) Research shows that approximately 50% of miscarriages are due to chromosomal abnormalities, which couples have no control over.  These losses are do not raise the risk for future miscarriages. 2) Blood clotting disorders cause a significant number of miscarriages and the use of heparin and aspirin during pregnancy has been shown to raise the chances of successfully carrying a baby to term.  Because I read this book, I was able to get testing and rule out blood clotting disorders after my second loss. (My doctor would not have mentioned them until after my third.)

I would caution women from reading this book right after a miscarriage.  Give yourself a few months to heal and read some of the more compassionate experience-sharing books first.  (I recommend After Miscarriage and Angels in my Heart.)  I found Coming to Term at times to be very difficult to read because it approached miscarriage in a clinical way.  In addition, there is frequent reference to abortion (there are very strong links between abortion and miscarriage research), fertility treatments that do not respect the dignity of life, and surrogacy, all of which bring up ethical/moral issues and may be difficult to handle soon after a loss.

A consumer-focused view of parenthood that treats babies as a commodity to be obtained runs throughout the book, though it certainly isn't the author's focus or even his intention; he simply includes stories of real couples, many which unfortunately include elements of this.  It is worth reading this book for the valuable medical information it contains; however, make sure you have healed enough and are prepared to be confronted by these issues.

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